Language
English
Publication Date
6-1-2023
Journal
Journal of Acquired Immune Deficiency Syndromes
DOI
10.1097/QAI.0000000000003184
PMID
36881792
PMCID
PMC10293071
PubMedCentral® Posted Date
6-1-2024
Abstract
Background: Despite the growing concern that people with HIV (PWH) will experience a disproportionate burden of dementia as they age, very few studies have examined the sex-specific prevalence of dementia, including Alzheimer disease and related dementias (AD/ADRD) among older PWH versus people without HIV (PWOH) using large national samples.
Methods: We constructed successive cross-sectional cohorts including all PWH aged 65+ years from U.S. Medicare enrollees and PWOH in a 5% national sample of Medicare data from 2007 to 2019. All AD/ADRD cases were identified by ICD-9-CM/ICD-10-CM diagnosis codes. Prevalence of AD/ADRD was calculated for each calendar year by sex-age strata. Generalized estimating equations were used to assess factors associated with dementia and calculate the adjusted prevalence.
Results: PWH had a higher prevalence of AD/ADRD, which increased over time compared with PWOH, especially among female beneficiaries and with increasing age. For example, among those aged 80+ years, the prevalence increased from 2007 to 2019 (females with HIV: 31.4%-44.1%; females without HIV: 27.4%-29.9%; males with HIV: 26.2%-33.3%; males without HIV: 21.0%-23.5%). After adjustment for demographics and comorbidities, the differences in dementia burden by HIV status remained, especially among older age groups.
Conclusions: Older Medicare enrollees with HIV had an increased dementia burden over time compared with those without HIV, especially women and older subjects. This underscores the need to develop tailored clinical practice guidelines that facilitate the integration of dementia and comorbidity screening, evaluation, and management into the routine primary care of aging PWH.
Keywords
Male, Aged, Humans, Female, United States, Medicare, Dementia, Cross-Sectional Studies, HIV Infections, Alzheimer Disease
Published Open-Access
yes
Recommended Citation
Yu, Xiaoying; Kuo, Yong-Fang; Raji, Mukaila A; et al., "Dementias Among Older Males and Females in the U.S. Medicare System With and Without HIV" (2023). Faculty, Staff and Students Publications. 6761.
https://digitalcommons.library.tmc.edu/baylor_docs/6761